PRESTON S SMITH (PA-C) – Physician Assistant, NPI 1992794929

PRESTON S SMITH (PA-C) is a healthcare provider. based in Boise, Idaho. specializing in PHYSICIAN ASSISTANT. They hold the professional credentials PA-C. They hold a License No. PA464 (ID). The NPI Number for PRESTON S SMITH (PA-C) is 1992794929

Main info

Male
23 Years Of Experience
Name
PRESTON S SMITH (PA-C)
NPI
1992794929
Phone
(208) 381-2222
Address
190 E BANNOCK ST
Enumeration Date
21 October 2005
Last Update Date
1 November 2023

Doctor Profile

Medical School Name
OTHER
Secondary Phone
2083770820
Graduation Year
2003 (23 years ago)
PAC ID
1355238387
Group Practice PAC ID
5395833586
Professional Enrollment ID
I20040303000558
Address ID
ID837048734BO6454XSTXX400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience64
Completeness75
Years active:20State licenses:1Digital endpointsOther names

1,534 PHYSICIAN ASSISTANT in ID

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Provider Addresses for PRESTON S SMITH (PA-C)

  • St. Luke's Boise Medical Center, 190, East Bannock Street, Downtown, Boise, Ada County, Idaho, 83712, United States

    BOISE, ID 837126241

    Phone: (208) 381-2222

    Fax: (208) 463-3044

    Type: Mailing

  • 215 E HAWAII AVE

    NAMPA, ID 836866011

    Phone:

    Type: Mailing

  • Saltzer Medical Group, 215, East Hawaii Avenue, Nampa, Canyon County, Idaho, 83686, United States

    NAMPA, ID 836866011

    Phone: (208) 468-5930

    Fax: (208) 463-3044

    Type: Location

  • 500 W. Fort St.

    # 111

    Boise, ID 83702

    Phone: (208) 422-1000

    Fax: (208) 422-1319

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 1 Open Payments records for all available years, with a total value of $125.

Total Amount is formed as General ($125) + Research ($0) + Ownership ($0) = $125.

Last reported payment date: 2024-11-07 • Largest payer in this snapshot: ABBVIE INC. ($125).

Total Amount

$125

General + Research + Ownership

Payments

1

Total payment records

General Amount

$125

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-11-07

Latest reported date

Top Companies

Largest payers in this snapshot

CompanyAmount
ABBVIE INC.$125
View all Open Payments →|Open Payments Risk Radar →

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2004-03-03

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20040303000558IPhysician AssistantIDTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 83712)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 5395833586View full group profile
NameSpecialtyState
Physician AssistantMA
Physician AssistantID
-ID
D E R M A T O L O G YIL
Physician AssistantID

Reviews

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Frequently asked questions

Can I use this page to confirm PRESTON S SMITH (PA-C)'s NPI?
Yes. PRESTON S SMITH (PA-C) is listed with NPI 1992794929 in the public NPI dataset.
Does CMS list PRESTON S SMITH (PA-C) as active?
Yes — PRESTON S SMITH (PA-C) is active in the NPI listing used on this page.
What taxonomy line describes PRESTON S SMITH (PA-C)?
For research purposes, treat PRESTON S SMITH (PA-C) as Physician Assistant in this dataset. Clinical services aligned with this taxonomy classification.
What address line appears for PRESTON S SMITH (PA-C)?
PRESTON S SMITH (PA-C)'s geographic hint is Boise, Idaho in our summary view.
What does 'Individual Provider' mean on this profile?
Entity type tells you whether the number belongs to a person or an organization.

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